Individual
JUAN LUIS VILLASECA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
491 KAMALU RD, KAPAA, HI 96746-8101
(206) 910-1085
Mailing address
491 KAMALU RD, KAPAA, HI 96746-8101
(206) 910-1085
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0987
INDIVIDUAL
HI
Enumeration date
03/11/2015
Last updated
03/11/2015
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